Mental health and gun violence

Published: Thursday, January 24, 2013 at 08:07 PM.

One of the most common proposals to reduce gun deaths, and one that has the most public support, is to keep firearms out of the hands of the mentally ill.

Both President Obama and the National Rifle Association advocate “fixing our broken mental health system.”

It’s a worthy goal. The path to reaching it, though, is not a straight line. Policymakers and law enforcement officials must be cautious of the many twists and turns.

“Mental health” is a term that encompasses a vast array of conditions, from mild depression to violent schizophrenia.

Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute, points out that although severely ill people whose symptoms are unmedicated are indeed at higher risk for committing violence than treated individuals, they account for only 3 to 5 percent of violent crimes in the general population.

Furthermore, they are more likely to use a gun to kill themselves than to harm others.

A broad approach that overstates the risk threatens to stigmatize the mentally ill. Identifying those who pose dangers, to themselves and to others, is an inexact science, to say the least. The risk in the current climate is to “better be safe than sorry,” leading to some people being unfairly classified and put on a list, depriving them of their legitimate Second Amendment rights.

One of the most common proposals to reduce gun deaths, and one that has the most public support, is to keep firearms out of the hands of the mentally ill.

Both President Obama and the National Rifle Association advocate “fixing our broken mental health system.”

It’s a worthy goal. The path to reaching it, though, is not a straight line. Policymakers and law enforcement officials must be cautious of the many twists and turns.

“Mental health” is a term that encompasses a vast array of conditions, from mild depression to violent schizophrenia.

Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute, points out that although severely ill people whose symptoms are unmedicated are indeed at higher risk for committing violence than treated individuals, they account for only 3 to 5 percent of violent crimes in the general population.

Furthermore, they are more likely to use a gun to kill themselves than to harm others.

A broad approach that overstates the risk threatens to stigmatize the mentally ill. Identifying those who pose dangers, to themselves and to others, is an inexact science, to say the least. The risk in the current climate is to “better be safe than sorry,” leading to some people being unfairly classified and put on a list, depriving them of their legitimate Second Amendment rights.

Mental health professionals shouldn’t be placed in the position of being psychics, trying to predict who will commit offenses a la the “pre-crime” enforcement of science fiction (see “Minority Report”).

This already can be seen in New York state, which recently hastily passed gun control legislation in the wake of Sandy Hook. The law requires therapists, doctors, nurses and social workers to tell government authorities if they believe a patient is likely to harm himself or others. That could lead to revoking the patient’s gun permit and seizing his guns.

Mental health experts responded that they feared that provision would discourage people from seeking treatment, which could make the current situation even worse. Far too many Americans already slip through the nation’s mental health safety net. For many, incarceration is their best opportunity to receive help. That is often inadequate and too late.

Ideally, the nation will approach the issue holistically — improving mental health services for their own sake, not simply as a tool of law enforcement aimed at a few potential threats.